Psychiatry International

Background: The Strengths and Difficulties Questionnaire (SDQ) has largely been used in adolescents to screen for mental health difficulties and prosocial capabilities. The objective is to analyze the psychometric properties of the Spanish version of the SDQ in university students. Methods: This work included a large sample (N = 1256), 64.6% women with a mean age of 22.96 years (SD = 6.15). Results: The confirmatory factor analysis indicated that a six-factor solution was the most tenable. The study of measurement invariance (MI) revealed strong measurement invariance both by gender and age. The study of relations with other variables indicated that the SDQ subscales were statistically significantly correlated with indicators of self-esteem, emotional well-being, stress, and emotional regulation. Finally, the internal consistency of the scores for the Total Difficulties Score was 0.763. Conclusions: These results allow confirming the psychometric properties of the Spanish version of the SDQ for its use in university students. Full article

Artificial intelligence (AI) technologies are becoming increasingly integrated into the everyday lives of children, influencing how they learn, communicate, and develop emotionally. As AI assumes a more central role in children’s digital ecosystems, AI literacy—the ability to understand, engage with, and make informed decisions about AI systems—is no longer a luxury but a developmental necessity. This review explores how AI literacy intersects with children’s mental health, particularly through the lens of socioeconomic status. Drawing on Digital Capital Theory and Cumulative Advantage/Disadvantage Theory, the paper examines how inequalities in access to AI-related resources shape the emotional and psychological experiences of children. It argues that while AI literacy can enhance well-being across all social groups, its impact is especially transformative for children from low-income backgrounds. Children from middle- and high-income families often experience modest emotional gains from AI engagement, having already benefited from consistent digital exposure and support. In contrast, low-income children—who often begin with limited access and lower confidence—stand to gain disproportionately in terms of emotional resilience, self-esteem, and digital confidence when their AI literacy improves. The review concludes with policy and practice recommendations that prioritize equitable access and tailored interventions, especially for underserved populations who have the most to gain from both the cognitive and emotional benefits of AI literacy. Full article

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) frequently persists into adulthood and is characterized by heterogeneous clinical presentations influenced by gender, demographic and psychosocial factors. Although gender-related differences in adult ADHD have been reported, individuals residing in rural settings remain underrepresented in empirical research. Guided by Gender-Based Analysis Plus (GBA+) framework, this study examined gender differences and psychosocial correlates of ADHD subtypes among adults in a rural Canadian population. Methods: A cross-sectional study was conducted using de-identified medical record data collected between February 2021 and January 2024 from a rural outpatient clinic in Northern British Columbia, Canada. The sample comprised 660 adults aged 19 years and older with a documented ADHD diagnosis. The combined presentation was the most common (67.0%), followed by the inattentive presentation (30.3%), while the hyperactive/impulsive presentation was rare (2.7%). In bivariate analyses, ADHD presentation was not significantly associated with gender, age group, employment status, or marital status. Prescribed ADHD medication differed across presentations (χ² (1) = 12.36, p < 0.001), with a higher proportion of individuals with the inattentive presentation reporting pharmacological treatment. In the pooled logistic regression model, prescribed ADHD medication was the only variable independently associated with presentation (OR = 0.54, 95% CI 0.38–0.77, p = 0.001). In gender-stratified models, this association remained evident among women, whereas no stable inferential conclusions could be drawn for men or gender-diverse participants. Conclusions: Within a GBA+ perspective, the findings suggest that gender may shape recognition and entry into care, rather than the clinical subtype identified at assessment, underscoring the need for a comprehensive assessment in rural clinical practice. Full article

This study aimed to examine the differences in self-compassion (SC) subcomponents between anorexia nervosa (AN) subtypes, the restricting type (ANR) and binge-eating/purging type (ANBP), with a focus on perceived isolation and self-judgment. This retrospective exploratory study included 40 patients with AN at a Japanese tertiary hospital. The participants completed the Self-Compassion Scale, Patient Health Questionnaire-9, and Eating Disorder Examination Questionnaire. Between-group comparisons were conducted using t-tests, and logistic regression was used to examine associations with the AN subtype. Compared with the ANR group, the ANBP group was older at the time of assessment, had a longer illness duration, and showed significantly more depressive symptoms, more severe eating pathologies, and lower SC scores. Specifically, patients with ANBP had significantly higher scores on the negative SCS subscales of self-judgment and isolation, indicating greater self-criticism and perceived isolation. In logistic regression analyses adjusting for the EDE-Q mean score, higher isolation scores were significantly associated with the ANBP subtype (odds ratio = 3.28, 95% confidence interval: 1.37–9.63, p = 0.01). In this exploratory sample, perceived isolation was more prominent in ANBP and may reflect affective and interpersonal difficulties related to this subtype. These findings should be interpreted as hypothesis-generating and warrant replication in larger (ideally multi-site and longitudinal) samples. If replicated, targeting these self-compassion dimensions may inform the development of subtype-sensitive interventions. Full article

The rising prevalence of physical comorbidities among patients with mental illness has increased the relevance of physical rehabilitation within psychiatric care. However, specific physical rehabilitation practices in specialized psychiatric hospitals in Japan remain insufficiently documented. This exploratory and descriptive study aimed to characterize the rehabilitation content provided and to categorize patient characteristics and comorbidities in a single specialized psychiatric hospital using an expert-led consensus approach. Clinical data from 150 patients (median age 71.0 years) who received physical rehabilitation were retrospectively analyzed. Patient categorization was conducted through a multidisciplinary consensus-building process involving an expert panel of physical therapists, occupational therapists, psychiatrists, and nurses, each with over 10 years of clinical experience. Using a hierarchical rule set based on International Classification of Diseases, 10th Revision (ICD-10) codes and clinical referral data, five distinct categories were identified: Disuse Syndrome (41%), Neurologic Disorders (20%), Lower Limb Lesions (18%), Parkinson’s Syndrome (15%), and Upper Limb Lesions (6%). Across all categories, rehabilitation interventions focused on foundational motor therapies, such as range of motion (27%) and strength training (23%). Mobility-oriented interventions were selectively provided to patients with high bedridden status based on clinical potential. Overall, practices in this setting primarily targeted disuse syndrome and maintenance of basic motor function and were delivered with input from multiple professional disciplines; such practices may inform future research on structured multidisciplinary rehabilitative approaches, especially for aging psychiatric populations. Full article

In recent years, imaginative techniques have effectively addressed the growing demand for brief, evidence-based treatments applicable in various contexts. Among these, Imagery with Rescripting (ImRs) was developed within the Schema Therapy model. ImRs can be applied individually or in combination with other protocols, demonstrating significant outcomes even after just one session. This narrative review aims to provide an overview of the applications of ImRs, with a specific focus on its effectiveness in trauma-related disorders. The search string used was “(‘imagery with Rescripting’) AND ((‘Trauma’ OR ‘PTSD’ OR ‘dissociation’))”. The following databases were utilized: PubMed, Scopus, Web of Science, Medline, Embase, and PsychInfo. The research included English-language and Italian-language studies, encompassing experimental and observational designs, case reports, and case series. Samples consisted of healthy participants or clinical populations aged 18 years and older, with no temporal limitations. A total of 56 articles were selected. The results highlight the efficacy of this intervention, whether administered individually or as part of combined protocols, across a wide range of diagnostic categories, including healthy samples, post-traumatic stress disorder (PTSD), borderline personality disorder (BDP), sleep disorders, psychotic spectrum disorders, chronic pain, anxiety disorders, depression, and eating disorders. The studies also support hypotheses about the mechanisms underlying the technique: ImRs facilitates the reprocessing of the meaning associated with mental representations and reduces the occurrence of negative intrusive images related to past events. This process alters and rewrites the individual’s negative memories and images. The narrative review supports the effectiveness of ImRs in treating various psychopathological disorders, both trauma-related and non-trauma-related. In addition to highlighting the effectiveness of ImRs when appropriately integrated with other techniques, the review emphasizes the importance of conducting efficacy studies on larger samples to evaluate ImRs as a standalone intervention model. Full article

Fairbairn’s structural theory of mind is an effective framework in Object Relations Psychotherapy for understanding the internal organization of Object Relations structures. However, traditional Object Relations psychotherapy relies heavily on verbal intervention. This raises a critical hypothesis: can these frameworks be effectively integrated with non-verbal expressive therapies, and can artistic output symbolize internal Object Relations structures? This study integrates Fairbairn’s theories with the Expressive Therapies Continuum (ETC) to address this gap. This integration is particularly vital for non-verbal populations where mental health constraints or emotional overwhelm hinder verbalization. This paper presents a detailed case study of a 20-year-old Malaysian male diagnosed with schizophrenia, who presented with severe trauma and profound Alogia. Following one year of integrated Object Relations Expressive Psychotherapy, the client’s progress is analyzed. Seven of his paintings are presented to illustrate how shifts in his object relations were symbolized and processed through his expressive work. Full article

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) has been less frequently and extensively investigated in university students than in children, despite substantial evidence demonstrating its significant impact on academic performance and negative affect, such as anxiety. We conducted two studies to address this gap. Methods: The objective of our first study (n = 233) was to assess the prevalence of subclinical ADHD among medical students and examine its associations with comorbid mental health conditions, such as Depression, Anxiety and Stress (DASS-21). In the second pilot intervention study (n = 16), we compared the ratio of negative and positive emotions (PANAS) and anxiety (STAI-S-5) before and after neurofeedback-based relaxation training in two groups of students: one with high scores and another with low scores on the Adult ADHD Self-Report Scale (ASRS). Results: According to our results, more than 50% of students showed risk for ADHD symptoms, and linear regression analyses revealed a strong association between ADHD symptoms and the prevalence of negative affect. Interestingly, no significant differences were found in ADHD and DASS scale scores between students who were falling behind and those progressing in line with the curriculum. Further results of the second study were inconclusive in several areas. In the examined group, a significant increase was observed in one of the core symptoms of ADHD—mind wandering—by the end of the intervention, compared to the baseline. Additionally, frustration levels were significantly higher at the second measurement point among participants with higher ASRS scores. Conclusions: Compared to the literature, it can be concluded that while longer interventions tend to be effective, two sessions are insufficient to reduce symptom. Full article

Objective: This study aimed to compare the parent-reported quality of life (QoL) of children and adolescents diagnosed with a chronic mental health disorder to that of those with a chronic somatic disorder. Methods: A comparative analysis was conducted between two clinical groups: one comprising patients with psychiatric diagnoses and the other with somatic diagnoses. QoL was assessed using the CHIP-CE/PRF questionnaire completed by caregivers. Statistical analyses evaluated differences across domains such as well-being, self-esteem, peer relationships, family engagement, and academic performance. Results: Parents of children with somatic conditions reported significantly higher scores in the domains of health and well-being (U = 799.50, p = 0.002), peer relations (U = 872.50, p = 0.009), and academic performance (U = 445.50, p < 0.001). No significant differences were observed in emotional and somatic symptoms or behavior at home. Conclusions: The findings suggest that, from a parental perspective, psychiatric disorders are associated with lower perceived quality of life in several key areas of functioning. These results emphasize the need for targeted support strategies and coordinated care for families of children with mental health conditions. Full article

Background: Military police officers are exposed to occupational stressors associated with mental health, coping strategies, and work engagement. This study examined mental health indicators and their associations with coping strategies and work engagement among military police officers in the pre-pandemic period. Methods: A quantitative, cross-sectional, descriptive, and correlational study was conducted in 2018 with 773 Brazilian military police officers from São Paulo (n = 506) and Paraná (n = 267). Participants completed the Work Stress Scale (WSS), Maslach Burnout Inventory (MBI-HSS), Utrecht Work Engagement Scale (UWES), and the Scale of Problem Coping Modes (EMEP). Results: The prevalence of occupational stress was 30.2%, with high proportions of Emotional Exhaustion and Depersonalization. Burnout was interpreted dimensionally (MBI-HSS subscales), with 17.6% (n = 134) joint prevalence of the high Emotional Exhaustion + high Depersonalization + low Personal Accomplishment profile, alongside frequent mixed profiles (e.g., 38.3% with high Depersonalization + low Personal Accomplishment). In the multivariable model, the 6 h shift was associated with higher odds of stress (OR = 7.76; 95% CI: 1.02–58.79), while the absence of self-reported health/quality-of-life issues was associated with lower odds (OR = 0.60; 95% CI: 0.39–0.94), along with Emotional Exhaustion (OR = 1.15; 95% CI: 1.10–1.20) and Depersonalization (OR = 1.12; 95% CI: 1.04–1.20). In sensitivity analysis, work shift was not associated with stress (aOR = 1.20; 95% CI: 0.66–2.21). Stress and burnout dimensions were negatively correlated with work engagement (r = −0.52), problem-focused coping, and social support and positively correlated with emotion-focused coping. São Paulo officers reported higher engagement and greater use of problem-focused coping and social support, whereas those in Paraná reported greater reliance on emotion-focused coping. Conclusions: Stress and burnout dimensions may coexist with high engagement, supporting the need for integrated institutional strategies that address organizational stressors (e.g., workload schedules) and strengthen potentially protective coping repertoires, while accounting for contextual differences between units. The high prevalence of burnout profiles underscores the urgency of preventive interventions to mitigate syndromic manifestations in high-stress occupations. Full article

Suicide is a serious and global health problem, with important consequences for individuals and for society. Understanding health workers’ perspectives is important for understanding how clinicians think about this topic and their attitudes toward and adherence to current guidelines. These findings can also have implications for future directions in guideline development and suicide-prevention policy. The purpose of this study was to investigate health workers’ experiences with and perceptions of suicide risk assessments. We conducted an electronic survey in which we asked health workers (N = 183) 18 questions about their experiences with and opinions about suicide risk assessments, suicide prevention, risk factors for suicide, and questions relating to the Norwegian guidelines for suicide risk assessment. The health workers in this study consisted of psychologists, doctors, nurses, and social workers from three different Norwegian hospitals. We found that the professional groups differed significantly in their responses. We also found significant differences between staff at the different hospitals in how they perceived the risk factors and standardized questions. In general, the respondents were skeptical regarding the emphasis on standardized suicide risk assessments. Furthermore, respondents perceived suicide as at least partly preventable. There were some differences between professions and hospitals. This may be due to cultural and educational aspects. Suicide risk prevention is complex, involving a variety of factors. Methodological limitations should be taken into consideration. Future research should further explore health workers’ concerns about standardized suicide risk assessments. Full article

Marijuana use in the United States (U.S.) has diversified alongside expanding legalization, yet little is known about the psychosocial factors that distinguish medical from recreational use. This study examined whether psychological distress mediates the association between perceived social isolation (i.e., loneliness) and marijuana use type among U.S. adults. We analyzed cross-sectional, nationally representative data from the 2024 Health Information National Trends Survey (HINTS, cycle 7). Marijuana use was categorized as medical (including medical and both medical/recreational) versus recreational. Perceived social isolation was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) Social Isolation t-score, and psychological distress was assessed with the Personal Health Questionnaire (PHQ)-4. Survey-weighted descriptive analyses and a weighted structural equation mediation model accounting for the complex sampling design were conducted. Medical marijuana users reported significantly higher levels of psychological distress and perceived social isolation than recreational users. Greater social isolation was strongly associated with higher psychological distress, and higher distress was associated with a greater likelihood of medical (vs. recreational) marijuana use. The indirect effect of social isolation on marijuana use type through psychological distress was statistically significant, while the direct effect of social isolation was not significant after accounting for distress. Overall, greater perceived social isolation predicted medical marijuana use primarily through elevated psychological distress. These findings suggest that medical marijuana use among U.S. adults may reflect coping with psychological distress linked to social disconnection, underscoring the importance of integrating mental health and social context into clinical and public health approaches to cannabis use. Full article

(1) Background: The families of military personnel preparing for deployment are exposed to anticipatory stressors that may adversely affect their psychological well-being. This study aimed to examine the associations between anxiety, psychological resilience, and trait hope among the family members of military personnel during the pre-deployment period. (2) Methods: A cross-sectional online survey was conducted between 20 September and 20 December 2025 and included 73 Romanian adult participants. From a psychiatric perspective, anxiety during the pre-deployment phase represents a clinically relevant form of anticipatory distress that may benefit from early identification and preventive intervention. Anxiety was assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7), psychological resilience with the Brief Resilience Scale (BRS), and trait hope with the Adult Hope Scale (Agency and Pathways subscales). Pearson correlation analyses, multivariable linear regression, and hierarchical regression models were applied. (3) Results: Participants reported moderate anxiety levels (GAD-7 mean 7.52 ± 4.98). Anxiety was strongly negatively correlated with psychological resilience (r = −0.75, p < 0.001) and moderately negatively correlated with total hope (r = −0.67, p < 0.001), Agency (r = −0.61, p < 0.001), and Pathways (r = −0.64, p < 0.001). Psychological resilience emerged as a significant negative predictor of anxiety (β = −0.64, p < 0.001). Hierarchical regression showed that trait hope explained additional variance in anxiety severity beyond resilience and sociodemographic variables (ΔR² = 0.07, p < 0.001). (4) Conclusions: Psychological resilience and trait hope were independently and jointly associated with lower pre-deployment anxiety in military families, underscoring their relevance to preventive and community psychiatry as modifiable resources for early screening and non-pharmacological intervention. Full article

Background: The relationship between maternal thyroid function and psychiatric morbidity remains inconclusive, particularly regarding the association with antepartum depression (APD). This meta-analysis aimed to precisely quantify the association between the three primary maternal thyroid hormone concentrations—thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3)—measured in late pregnancy and in the presence of APD. Methods: We conducted a systematic review and meta-analysis of observational studies identified through comprehensive database searches (PubMed, Web of Science, Scopus). Four exploratory studies were ultimately included, enrolling a total of 689 participants. We used random-effects models to pool the mean difference (MD) in hormone concentrations between depressed and non-depressed cohorts. Subgroup analyses were performed based on the study population (general versus hypothyroid), and publication bias was assessed using Begg’s and Egger’s tests. Results: None of the pooled hormone concentrations demonstrated a statistically significant association with APD. The overall MDs were non-significant for TSH (MD = −0.07, 95% CI: [−0.32, 0.18], p = 0.59), FT4 (MD = −0.11, 95% CI: [−1.14, 0.92], p = 0.83), and FT3 (MD = 0.53, 95% CI: [−0.20, 1.25], p = 0.15). Substantial and significant heterogeneity was detected across all models (I² ranging from 70% to 94%). This heterogeneity was largely driven by conflicting directional findings (some studies linking APD to hypothyroid trends, others to hyperthyroid trends), masking a potential non-linear or categorical effect. Statistical tests found no significant evidence of publication bias for TSH (p = 0.33), FT4 (p = 0.12), or FT3 (p = 0.33). Conclusions: The absolute mean concentrations of TSH, FT4, and FT3 in late pregnancy are not robust concurrent biomarkers for antepartum depressive symptoms. The high heterogeneity suggests that APD may be associated with categorical dysfunction (i.e., TSH levels at the extreme high or low ends of the reference range) rather than linear changes in hormone concentration. Future research should prioritize investigating categorical risks, the influence of thyroid autoimmunity, and employing gold-standard diagnostic interviews to better delineate the complex endocrinological risk factors for APD. Due to the limited number of studies, these results should be considered hypothesis-generating rather than confirmatory. PROSPERO registration: CRD420251233154. Full article

Individuals living with inflammatory bowel disease are at a heightened risk of developing certain psychiatric disorders and the gut–brain axis has been proposed as a potential contributor. In the context of the relationship between inflammatory bowel disease and psychiatric disorders, this comprehensive review examines the influence of the gut–brain axis by addressing (i) psychiatric comorbidity, (ii) the role of the gut microbiome and its metabolites, (iii) therapeutic approaches for depression and anxiety, and (iv) psychosocial stressors and microbiome interactions. There is a bidirectional relationship between inflammatory bowel disease and psychiatric conditions, particularly anxiety and depression, which arises from a complex interplay of genetic susceptibility, dysregulation of the gut–brain axis, and neuroimmune processes. Disturbances in gut microbiome composition represent a core mechanism underlying psychiatric comorbidities related to inflammatory bowel disease, although a substantial body of the current knowledge is derived from preclinical models. The integration of microbiome-based therapies into routine clinical practice is still in its early stages, which highlights the need for further research to establish their safety and effectiveness. A deeper understanding of the differences between Crohn’s disease and ulcerative colitis is also pivotal for interpreting therapeutic responses. Ultimately, innovations in nutritional psychiatry and precision medicine hold promise for improving the lives of patients affected by these physical and mental comorbid conditions. Full article

Background: Medical students often face substantial psychological stress, which can increase the risk of substance use, professional detriment, and insufficient patient care. However, substance use in medical students remains understudied in Iraq. This study highlights the prevalence, patterns, risk factors, and negative effects of substance use among medical students at the University of Baghdad. A cross-sectional study involving 414 medical students at the University of Baghdad was conducted. The questionnaire included sociodemographic variables and the Alcohol, Smoking, and Substance Involvement Screening Test to screen for psychoactive substance use. The lifetime prevalence of substance use was 38.9%. Among substance users, 42.8% used nicotine, 22.3% used sedatives, 4.3% used inhalants, and 3.1% used amphetamines, with only 27.3% reporting polysubstance use. Through multivariate logistic regression, it was identified that males are approximately 2.8 times more likely to use substances compared to females (OR: 2.8, 95% CI: 2.1–5.2, p-value < 0.001), and students with a positive family history of substance use are approximately 3.1 times more likely to use substances compared to those without (OR: 3.1, 95% CI: 2.8–7.5, p-value < 0.001). These findings underscore the importance of implementing early preventive strategies, targeted mental health interventions, and substance use awareness programs within Iraqi medical institutions. Full article

Background: Psychiatrists operate at the interface of clinical care, legal frameworks, and governmental power, where external pressures and insufficient safeguards can potentially engender ethical vulnerabilities. Supranational instruments and wider professional standards notwithstanding, the extent to which national-level psychiatric associations articulate protections against torture and abusive practices in their ethical codes remains underexplored. Methods: A cross-sectional documentary audit was conducted of all 145 World Psychiatric Association (WPA) Member Societies, representing ≈250,000 psychiatrists globally. National-level psychiatric ethical codes were located via systematic web searches and examined for clauses specifically referencing torture or analogous abuses and for any associated enforcement procedures. Results: Only nineteen (13.1%) WPA Member Societies maintained publicly accessible ethical codes, with ten (6.9%) containing explicit provisions proscribing torture and associated abuses. These predominantly originated from high-income countries or jurisdictions with documented histories of human rights violations. Most codes invoked broad principles without directly addressing such abuses, and fewer than half delineated any enforcement mechanisms. Conclusions: Gaps persist in ethical governance and human-rights safeguards amongst WPA Member Societies. Although beneficence and non-maleficence provide moral foundations for psychiatric practice, generic commitments alone may prove inadequate under duress. Strengthening anti-torture prohibitions within national-level psychiatric codes could therefore help support ethical resilience and accountability in situations of institutional or political coercion. Full article

Amblyopia is the most common cause of unilateral visual impairment in childhood. Occlusion therapy remains the gold standard for treatment as its psychosocial and functional consequences may affect both children and their parents, potentially compromising treatment adherence. This cross-sectional study included 36 children (aged 3–9 years) undergoing occlusion therapy for amblyopia and 18 parents who completed a mirrored version of the same questionnaire. Each instrument consisted of 18 items distributed across three domains: Psychosocial (Q1–Q6), Daily and School Activities (Q7–Q12), and Physical and Treatment Acceptance (Q13–Q18). Responses were coded on 0–3 or 0–1 scales, and total scores ranged from 0 to 26, with higher scores reflecting greater psychosocial impact. The mean total score reported by children was 15.3 ± 2.5 (range 10–22), compared to 16 ± 2.7 (range 10–21) for parents. No significant difference was found between the two groups (p = 0.31), indicating a generally consistent perception of treatment impact. Among children, girls (15.5 ± 2.4) scored slightly higher than boys (15 ± 2.5) (p = 0.51). Among parents, mothers (17 ± 2.5) reported significantly greater perceived impact than fathers (14 ± 3.0) (p = 0.03). Age-based comparison revealed no significant differences between age groups (3–4, 5–6, and 7–9 years; F = 0.14; p = 0.87), although younger children (3–6 years) showed slightly higher psychosocial scores than older ones (7–9 years) (p = 0.75). Occlusion therapy exerts a moderate psychosocial impact on amblyopic children, affecting emotional well-being, school performance, and treatment acceptance. While parents generally recognize the burden of therapy, mothers perceive it more strongly than fathers, and younger children appear slightly more emotionally affected. These findings emphasize the importance of including both child self-reports and parental perspectives in clinical assessments and support the need for psychological and educational interventions to improve comfort and adherence during treatment. Full article

Body image (BI) dissatisfaction has been associated with psychological distress and common mental disorders. This study aimed to estimate the prevalence of BI dissatisfaction within a community-based sample and examine its association with symptoms of depression, anxiety, and stress. A cross-sectional exploratory study was conducted with 255 adults aged 20–59 years recruited through non-probabilistic snowball sampling. BI dissatisfaction was assessed using the Stunkard Figure Rating Scale, and symptoms of depression, anxiety, and stress were evaluated using the DASS-21. Associations were examined using binary logistic regression models adjusted for sociodemographic covariates. In the study sample, the prevalence of BI dissatisfaction was (87.1%), predominantly related to perceived excess weight (75.1%), especially among women (81.0%). Dissatisfaction related to thinness was less frequent (12.0%) and more common among men (20.9%). After adjustment, dissatisfaction related to perceived excess weight was associated with higher odds of anxiety (OR = 4.54; 95% CI 1.63–10.70) and depression (OR = 4.24; 95% CI 1.60–10.24). No statistically significant association was observed with stress. BI dissatisfaction, particularly dissatisfaction related to perceived excess weight, was associated with depressive and anxiety symptoms in this adult sample. These findings contribute to understanding the relationship between BI dissatisfaction and emotional symptoms in adults, within the context of a cross-sectional, non-probabilistic design. Full article